| NPI | 1083008742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WISE Md 540-667-8975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2024-09-03 |